EXCEL PROSTHETICS & ORTHOTICS, INC. (NPI# 1457440166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457440166 |
| Entity Type | Organization |
| Organization Name | EXCEL PROSTHETICS & ORTHOTICS, INC. |
| Practice Address |
1319 Sunset Drive Suite 203 Johnson City TN 37604-5474 |
| Mailing Address |
115 Albemarle Ave Se Roanoke VA 24013-2205 |
| Practice Telephone | 4349289027 |
| Practice Fax Number | 4349289028 |
| Mailing Telephone | 5409820205 |
| Mailing Fax Number | 5409826905 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2017-03-23 |
| Authorized Official Name | MR. DOUGLAS C WALTERS (PRESIDENT) |
| Authorized Official Telephone | 5409820205 |
| Authorized Official Credential | CPO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 4581452 | 05 | |
| VA | 009190198 | 05 | |
| VA | 009132694 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528192200 | Excel Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 807 Mercer St, Princeton, WV 24740-2907 | 2007-03-15 |
| 1427147123 | Excel Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 1700 Vineyard St, Bluefield, WV 24701-4025 | 2006-10-12 |
| 1609965318 | Excel Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 2255 Langhorne Rd, Suite 1, Lynchburg, VA 24501-1117 | 2006-10-12 |
| 1851480560 | Excel Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 312 S Main St, Danville, VA 24541-2926 | 2006-10-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EXCEL PROSTHETICS & ORTHOTICS, INC. | 115 Albemarle Ave Se, Roanoke, VA 24013-2205 |
| Street Address |
1319 SUNSET DRIVE SUITE 203 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-5474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023540267 | Bristol Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 114 W Springbrook Dr, Johnson City, TN 37604-1757 | 2017-03-28 |
| 1417138975 | Alexander Prosthetics & Orthotics Inc | Prosthetic/Orthotic Supplier | 1604 Lamons Ln, Johnson City, TN 37604-8224 | 2007-11-26 |
| 1124101373 | Footheals Prosthetics and Orthotics, Inc. | Prosthetic/Orthotic Supplier | 2406 Susannah St, Lower Level, Johnson City, TN 37601-1725 | 2006-10-23 |
| 1457443624 | Victory Orthotics & Prosthetics LLC | Prosthetic/Orthotic Supplier | 2333 Knob Creek Rd Ste 14, Johnson City, TN 37604 | 2006-09-28 |
| 1265452650 | Graybeal Orthopedic, LLC | Prosthetic/Orthotic Supplier | 107 E Myrtle Ave, Johnson City, TN 37601-4631 | 2006-07-20 |
| 1700185238 | Center for Orthotic and Prosthetic Care of North Carolina, Inc. | Prosthetic/Orthotic Supplier | 130 Oakdale Rd, Johnson City, NY 13790-1758 | 2011-03-23 |
| 1801076815 | Klemmt Ortho & Prost. Inc. | Prosthetic/Orthotic Supplier | 130 Oakdale Rd, Johnson City, NY 13790-1758 | 2007-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871100990 | Porsche Vaughn | Prosthetic/Orthotic Supplier | 2203 Clarksville Pike, Nashville, TN 37208-1053 | 2020-09-24 |
| 1245845148 | Hopeful Strands LLC | Prosthetic/Orthotic Supplier | 5852 Sunny Morning Dr, Memphis, TN 38141 | 2020-09-09 |
| 1134737562 | Carefluent Connect, LLC | Prosthetic/Orthotic Supplier | 60 Athlete's Way N, Suite 300, Mt Juliet, TN 37122-4440 | 2020-07-22 |
| 1609484450 | Crowned By Court Rx | Prosthetic/Orthotic Supplier | 6339 Charlotte Pike # 928, Nashville, TN 37209-2926 | 2020-07-17 |
| 1558982868 | Kcb Medical Wigs | Prosthetic/Orthotic Supplier | 4246 Hillgate Cv, Memphis, TN 38118-6739 | 2020-04-28 |
| 1154955268 | A Step Ahead Orthotics and Prosthetics, Inc | Prosthetic/Orthotic Supplier | 1415 Old Weisgarber Rd Ste 360, Knoxville, TN 37909-1327 | 2020-02-27 |
| 1942849914 | American Brace & Limb Enterprise, LLC | Prosthetic/Orthotic Supplier | 9333 Parkwest Blvd., 103, Knoxville, TN 37923 | 2019-12-23 |
| 1841834322 | Southern Orthocare, Inc | Prosthetic/Orthotic Supplier | 11440 Parkside Dr Ste 304, Knoxville, TN 37934-2662 | 2019-10-29 |
| 1366901779 | Vascular and Vein Institute of The South, Pllc | Prosthetic/Orthotic Supplier | 6029 Walnut Grove Rd Ste 109, Memphis, TN 38120-2112 | 2019-03-15 |
| 1043775745 | Restorative Health Services, Inc | Prosthetic/Orthotic Supplier | 103 N Willow Ave, Cookeville, TN 38501-2369 | 2019-02-06 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.